Though no precise data on the incidence of heart failure exists in Kerala, statistics from the Trivandrum Heart Failure Registry show that the state has a much younger demographic profile – at least 12 years younger – suffering from heart failure compared to Western nations like the US. Coronary artery diseases are the most common cause of heart failure, accounting for 71% of all cases. This was stated by doctors at the Amrita Institute of Medical Sciences in the run up to the Amrita Heart Failure Update 2018, a one-day meet of cardiologists from India and abroad on the management of heart failure.
Heart failure happens due to the inability of the heart to pump blood as per the requirement of the body. It has several symptoms such as breathlessness, swelling of the ankles and fatigue. Diseases of the heart muscles, heart valves or heart covering are prominent causes. India has among the highest heart failure rates in the world.
Said Dr. K. U. Natarajan, Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences, Kochi: “The estimated incidence of heart failure in India is about 1% of the adult population, which translates to at least 8 to 10 million patients across the country. Old age is associated with higher incidence of heart failure. While the incidence in people above the age of 65 is 1 in 100 people, for those above the age of 75, it is 7 in 100 people. Diabetes is the most common risk factor for developing heart failure in Kerala, and its rapidly increasing incidence is causing a spike in the incidence of heart failure too.”
Talking about the risk factors, Dr. Vijayakumar M., Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences, said: “A variety of health conditions can heighten the risk of heart failure including hypertension and kidney diseases as well as smoking. We are also seeing large number of diabetic patients with heart failure, which shows that diabetes is also a prominent risk factor for the people of Kerala. In addition, there are large number of young people with coronary artery diseases (blockages in arteries supplying blood to heart muscles) who go on to develop heart failure. The most important thing in preventing heart failure is to identify the risk factors and try to halt the progression of these health conditions.”
Added Dr. Rajiv C., Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences: “Female patients are more prone to death due to heart failure, and the mortality rate is about 9 percent for them during hospitalization. However, in a study, an additional 9.6 percent of female patients died during a 90-day follow-up period after hospitalization, making the cumulative mortality rate at 18.6 percent. At the end of one year after hospitalization for heart failure, the mortality rate for female patients was a whopping 31 percent. Compared to developed countries, the duration of hospitalization for heart failure patients is also longer in India.”
Talking about the latest treatment options for heart failure, Dr. Rajesh Thachathodiyl, Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences, said that medical science has been progressing rapidly and heart failure can now be treated with many types of surgeries, including a heart transplant. He said: “Implantable devices like automated implantable cardioverter-defibrillator (AICD) which detects and corrects abnormal beating of the heart, and Cardiac Resynchronization Therapy (CRT) which helps coordinate the contraction of heart muscles, are used for patients of heart failure. Several artificial hearts are also in development across the world, such as by Carmat, a French company. SensiVest is another device which heart failure patients can wear over their clothes. It monitors fluid buildup in the lungs (a common problem among patients of heart failure) and gives doctors advance warning of the impending trouble. A soft robotic sleeve which fits around the heart and compresses it in sync with its natural rhythm is another innovation taking place.”
The doctors were unanimous that to reduce the incidence of heart failure, the government needs to intensify the campaign to detect and treat health conditions such as hypertension, diabetes and obesity and discourage people from smoking. They said that it should also provide proper infrastructure, manpower and financial support to treat acute heart attacks effectively to prevent damage to the heart muscle.